Provider Demographics
NPI:1215960299
Name:RUBMAN, MEGAN (PT)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:RUBMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:BALDWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1205 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05408
Mailing Address - Country:US
Mailing Address - Phone:802-383-0400
Mailing Address - Fax:802-383-0420
Practice Address - Street 1:1205 NORTH AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05408
Practice Address - Country:US
Practice Address - Phone:802-383-0400
Practice Address - Fax:802-383-0420
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040-0003262225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1007007Medicaid
VT48729OtherBLUE CROSS/BLUE SHIELD
VT1007007Medicaid